Individual
MRS. RANDI D BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
925 S NEBRASKA ST, MARION, IN 46953-1874
(765) 664-7492
(764) 400-4466
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(844) 397-1311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009509A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300033704
—
IN
Enumeration date
10/30/2019
Last updated
02/15/2024
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